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As beautiful as our golden years can be, an unfortunate reality to aging is an increase in vulnerability. We all know as our greying hair turns lighter, we become a little more prone to falls and illness every day. We jovially discuss the ups and downs of aging with family and friends, what we do about them and where to find help for the solemn aspects of our care. But there is also a topic regarding elder care that we as caregivers, family members, friends – and as the aging person – should be aware of.

Elderly abuse is a subject that many don’t want to talk about but let’s face it, pretending it doesn’t exist won’t make it go away. Yes, we, Malaysians, are generally raised to value filial piety in our families and upbringing. Yet it is not a value that everyone subscribes to. We have to acknowledge that it could happen to us unintentionally or otherwise.

Elderly abuse, like any other types of abuse, has emotional and unpleasant connotations made all the more complex in a culture where family pride is often measured by “the action of one reflects the whole”. Coupled with the lack of specific laws for elder care in Malaysia, including the welfare protection of the elderly –consultant geriatrician Dr Rajbans Singh said to The Star identifying elderly abuse becomes a lot more difficult.

Yet allowing elderly abuse and its’ enabling factors to continue isn’t an option. One of the most dominant types of abuse is financial abuse, which can leave the elderly victim destitute when left unchecked. According to a recent study, Public Policy & Aging Report, the study of financial abuse conducted in countries around the world found it to be either the most or second most common type of elder abuse.

The result supports the findings of the Department of Social and Preventative Medicine under Universiti Malaya’s Medical Faculty – reported in The Star’s article titled Aging and abused by their own. The report states that financial abuse is the most prevalent abuse in urban areas of Malaysia followed by psychological abuse. In rural areas the reverse is true.

Furthermore, according to an article in Forbes financial abuse of the elderly typically overlaps with other types of abuse such as physical, sexual, emotional or psychological abuse and neglect. With elderly abuse generally going unreported – as many see it as a “family problem” to be dealt with behind closed doors – attempting to curb it is all the more difficult. The problem will only grow as the elderly population in Malaysia increases to 15% by 2030.

Hence, to boldly address elder abuse we need to know how to identify it and be vigilant. Here are the defined signs of financial elder abuse in a domestic setting to look out for:

Financial abuse of the elderly

The National Centre on Elder Abuse defines financial or material exploitation as the “illegal or improper use of an elder’s funds, property, or assets”. In other words, if your money and assets – or your parent’s – is used without permission or in a fraudulent manner in any way, shape or form, it’s financial abuse.

Below are a few examples of the signs of financial abuse to be aware of that something is amiss. However, the list is not exhaustive and doesn’t begin to scratch the surface of bad scenarios. You need not look further than the 72 year old man with dementia that was abandoned by his son at a bus station.

Sudden changes in your bank account with unexplained large sums of withdrawals

Discovery of signatures being forged for financial transactions or titles of other assets

When it comes to financial exploitation, we imagine someone behind a computer screen or a stranger tempting us with a convincing too-good-to-be-true scam for our money. While there are such cases, the reality is that ‘someone’ may not be a stranger. Our families and closest friends usually have our best interests at heart, but isn’t always the case. They can fail you as much as anyone else with dire consequences.

According to Health Link, financial abuse typically involves a family member or another person whom the older adult trusts. The abuse occurs when said family member or friend takes control of the financial decisions and the elderly person’s funds, sometimes not even intentionally.

As mentioned by Dr Rajbans Singh in The Star, most cases of unintentional abuse he has encountered are due to the lack of knowledge and understanding of elderly care by the caregivers or family members. Adult children may not realise that their actions are financially abusive or neglectful toward their parents due to their bad decision.

Intentional abuse and blind faith

On the other hand, there is the occasional rotten apple where a family member is intentionally abusive. You may have a family member with some form of impairment – such as substance abuse or mental illness – who has a dependency on you or your parents for varied reasons – like housing, transportation, money and even care – and typically relies on intimidation or physical abuse to get their way.

Understandably, you may be reluctant to take any action and resign yourself to become a victim of abuse because of familial ties. He is your son, daughter, brother, sister, etc. you may say. However, this is not someone you want managing your finances and it goes without saying; doing so does not improve relationships.

Much like The Star’s report on the 68-year-old clerk, whose son turned hostile after she handed him control of her finances and assets, it is unlikely the abuser’s behaviour will change with the handover of your financial resources. The end result of doing so would leave you impoverished financially and relationally.

Bear in mind you do not deserve abuse in any form, what more from any family member. Your accumulated wealth is the result of your hard work and you – or your elderly parents– deserve care when age catches up.

Seek preventive measures

Regardless of the cause of abuse – unintentional or otherwise – the fact is medical expenditure is costly and according to the Malaysian Health Insurance, medical treatment costs double every five years. You would need your funds to ensure you receive the care and support you deserve. Additionally, you also need to consider paying for living expenses other than the medical expenditure and care-support. Less you or your parents end up not having money to survive and living on the sidewalks.

Your golden years deserve to be one that is lived with dignity and happiness, a reward for the hard work and care you have given or received. Mistakes from ill-advised decisions or greed should not take that away from you.

To that end it would be prudent to obtain a living trust – a trust that acts like a will while you are alive and whereby you set money aside for your care – that is managed by a team of credible and experienced professionals. Hence, you would mitigate the chances of financial abuse in your later years. You should also seek out a professional Care Manager, who has access to extensive resources for consultation on the care-support you need, thereby avoiding bad decision-making related to care.

The task of caring for an aging parent or a loved one can be intensely overwhelming, emotionally and financially, and the current infrastructure of healthcare service delivery in Malaysia can at times aggravate the situation further.

Some of these hitches in the healthcare service delivery might already be familiar to you: long waiting periods at public hospitals, crowded waiting areas, problems with accessibility, additional spending for travelling and the high cost of private healthcare.

Bearing witness to an aging parent or loved one’s physical or mental deterioration is never easy, especially when you recall the days when you were the recipient of their care. In either case, we want peace of mind from the assurance that we have got all our bases covered for ourselves and our loved ones in terms of safety and comfort.

Today, new technologies have created new possibilities – from aged-friendly communities to products and services – to reduce isolation and enhance quality of life without compromising the main thing today’s aging population are most interested in: independence and living with dignity.

Here are some ways the aging parent can still be independent and how much the independence could cost:

Safety

1. ICE – in case of emergency

Caregivers lose sleep over the well-being of their charge, but with this app, they may be able to get the peace of mind they need. In an emergency, the ICE app is a convenient and useful way to store essential information.

The free app allows you to record information regarding your medication, diseases (if any), allergies and other health-related information, in addition to a list of your emergency contacts.

Another feature of the app is the ability to create multiple profiles, which is useful for compiling a database of medical information about your family members or other loved ones as well. With the information obtained from the app, doctors can quickly assess your condition and apply more accurate solutions in the event of an emergency.

With a quick tap of the alarm button, an SMS is sent to your emergency contacts during a critical situation, containing data collected from your mobile phone and your location via GPS. It also allows you to store your health insurance policy number.

Name: ICE

Type: App

Operating system: Android

Price: Free

Name: Smart-ICE

Type: App

Operating system: iOS

Price: RM4

2. Alert Family Emergency Button

Pair ICE with the Alert app and you will have a personal digital telehealth monitoring. There is a similar emergency notification function that sends an SMS of your location to three of your contacts by merely tapping the Alert button or shaking your phone to activate it.

However, unlike ICE, it doesn’t store your medical information but it does simultaneously call your selected contacts and attempt to initiate a voice conference call to troubleshoot your situation. This is especially useful to guide your family or friends through steps they need to take if there is an emergency.

Name: Alert Family Emergency Button

Type: App

Operating system: Android & iOS

FREE version: 3 phone calls only

Full version: No call restrictions – RM40/month or RM400/year

Doctor Checkups

3. MYDOC.asia

Telehealth is a growing aspect in aged care but for Malaysians, we do still want to have the personal touch from a doctor to examine our condition, especially for specialised treatments.

While it’s not an app, MYDOC.asia is a free and useful website for you to get connected with a doctor.
Gone are the days where finding a specialist is a trial and error routine based on hearsay. MYDOC.asia allows you to search for a clinic or a specialist near you or anywhere in Malaysia. Essentially, the site provides information to help you make informed decisions when choosing your medical or healthcare service provider.

You can view the doctor’s experience, patient reviews and the quality of the clinics or facilities. You can personally chat with their Care Team for real time answers to your enquiries. Their operational hours are from 9am to 6:30pm.

This really comes into handy if you are travelling to a new place with your aging parents, as it allows the caregiver or the charge to look for the right doctor in case of emergency. Though MYDOC.asia is free to use, medical fees for consultation, treatment, and other services rendered by the selected clinic or doctor are still applicable.

Name: MYDOC.asia

Type: Website

Price: Free to use service

4. Doctor2U: Get a doctor

Even if your parent or your loved one does not need full-time care, living alone can be dangerous if one is not prepared for emergency.

The Doctor2U is a useful app to have on your phone to acquire medical assistance for non-life threatening cases. Doctor2U allows you to request for a visit from a certified doctor at the tap of a button.

The visiting doctor will arrive at your location in 60 minutes to diagnose, treat and prescribe the medication you require and follow up with you the next day. You have the option to choose whether the doctor is required for an adult or child. Upon acceptance, a doctor will attend to you. In the event of a life-threatening medical emergency, you would need to call 999 for medical assistance.

This especially useful for those who are living alone (aging or not), as something a fever can render us unable to drive to the clinic and back. With this app, you don’t have to leave your home and still get treated by a doctor.

Name: Doctor2U

Type: App

Platform: Android & iOS

Price of app: Free

Fee for services:
-RM250 for visits between 8am to 8pm
-RM420 from 8pm to 8am* Not including additional medication prescribed by the attending doctors

The app works similarly to how Uber, the ride-sharing app. Payments to the doctors would be done electronically using PayPal Braintree. This ensures that you are aware of the breakdown of the fees, as an email of the receipt and a medical summary report will be sent to you after every service.

Currently, Doctor2u is only operational in Kuala Lumpur, Penang, Ipoh and Johor and the service is available 24 hours, seven days a week.

Concierge services

5. Bemalas

As age progresses, running a simple errand outside of home can pose a great danger for your aging parent.

However, with Bemalas, an electronic personal butler, you don’t have to worry about the smaller daily tasks. The app is a Malaysian service that gives you the freedom to go about your daily routine at home while Bemalas attends to the errand you requested of them.

You can communicate with Bemalas through SMS at 012-643 1303 or chat with them through their app, website or Facebook page. You can request for a variety of errands, be it getting your medication, party planning, meal delivery or even an IT tutorial on how to use your smartphone or tablet.

They ensure your approval prior to proceeding with your request and will let you know if there are any issues with it. The charges of each task vary depending on complexity on top of their base fee. Bemalas operates from 9am-9pm nationwide daily.

Name: Bemalas

Type: App

Platform: Android & iOS

Price of app: Free

Fee for services: Charges vary depending on the task

Transportation

6. Uber and Grab (MyTeksi)

Mobility issues and getting around town becomes more difficult with age. With credible service providers like Uber and Grab (MyTeksi) to help with travelling without the issues of navigating traffic yourself or finding a parking lot, transportation is no longer an issue.

Uber charges a base fare of RM0.95, RM2.50 and RM3 – based respectively on their low (uberX), medium (uberXL), and high tier (uberBLACK) range of vehicles – in addition to the fare based on the distance and time you take to reach your destination.

Grab (MyTeksi) currently charges on a fixed rate basis with a base fare of RM4 and RM1.40 for the Premium and Economy ride respectively. For both providers, prior to confirming your ride, the estimated price is already calculated based on the base fare, distance between the two points, and estimated time taken to travel that distance.

Name: Uber & Grab (MyTeksi)

Type: App

Platform: Android & iOS

Price of app: Free

Fee for services: Fares depend on time and distance

A better flow of continuum care

The ‘uberisation’ of products and services has changed the game for traditional service providers, creating a generation of products and services that now empowers individuals via technology. It especially makes access to the provision of caregiving and personal independence more easily attainable.

The combination of the suggested apps gives a taste of the personal empowerment from having a custom-made service delivery network. However, this is only sufficient if you are an active retiree. Even then, putting aside factors of unexpected events, there is still room for human error when it comes to managing your own care.

The flow of caregiving from family members, especially when they are not professionally trained, can be disrupted due to emotions running high. In that moment, they may not necessarily decide on the optimal course of action.

Hence, it would be a good investment to have an experienced and objective third party as your Care Manager – backed by an array of resources, who can help you make informed decisions and execute them – to help ensure that you or your loved one receive the best care available in a continuous flow. The Care Manager can even help source for available and alternative options for you to mitigate obstacles – such as a crisis arising from a lack of funds for your care.

By having a Care Manager assist in shouldering some of the responsibilities, you will be able to gain a greater measure of respite and reassurance, knowing that your care or that of your loved ones is in good hands.

Disclaimer: The following is the opinion of the writer and the recipient acknowledges that Aged Care Group Sdn Bhd and its associated companies are unable to exercise control to ensure or guarantee the integrity of/over the contents of the information contained.